Sometimes the best treatment is none at all.

Well just when I thought my journey was all organised my most recent PSA has decided to head south again by the same 30% margin? Well while most welcomed, this has my physicians and myself somewhat dumbfounded. A see saw pattern seems to be emerging every six weeks. So it would appear that my BCR is neither progressing nor regressing at this stage. The catalyst? No idea, as the therapies for my co-morbidities have remained static. Stress? Well I really don't have any. I am quite comfortable with where I am on my journey. TBC.

Hi jfd

Can I ask what specific treatment you were advised would flare up your heart failure?

My dad is in a similar situation to you where he has multiple health issues, one of which is heart failure. He was prescribed Zoladex 12 months ago and since then he’s been admitted in hospital twice for fluid on his lungs which he had never experienced before starting Zoladex. He’s now rapidly declined and barely has the energy to get out of bed and we are wondering if this is being made worse by the Zoladex.

We don’t seem to have had as good advice as you regarding the heart failure and due to the multiple health issues we are just getting passed round in circles.

Any advice you could give would be much appreciated, thanks Lucy 

Reply to Lucy29

Hello Lucy,

                  The usage of ADT has been contraindicated in PCa patients with heart failure for a good period of time. General consensus is of the view that ADT in it's various forms may give rise to the development of heart failure in some individuals. So while the risk is known, treating physicians tend to try to balance treatment on the basis of dealing with the most life threatening co-morbidy. If PCa is rampant and heart failure in stage 1 or 2, then ADT may be considered appropriate and conversely visa versa as in my case. 

                 Forgive me Lucy, but I am trying to simplify what is a very complex medical situation. I think you should have a good chat with your Dad's physician. 

Edited by member 22 Jan 2026 at 06:59  | Reason: Not specified

Bone scan has now been reported on.

Head & Neck: No abnormal avid osteoblastic focus in the skull, facial bones, mandible, or in the cervical spine.

Thorax & Upper Limbs: Mild degerative pattern of uptake in the sternoclavicular and acromioclavicular joints. Physiological pattern of uptake in the clavicles and upper limb bones. A small focus of low grade uptake at the anterior aspect of the left 7th rib is non specific. Uptake in remainder of ribs is non specific.

The small focus uptake on the left 7th rib is an old # osasioned when I suffered the indignity of falling between the wharf and my yacht years ago.

Lumbar spine, Pelvis & Lower Limbs: Physiological pattern of uptake in the lumbar spine, pelvic bones, hips, and in the lower limb bones. Moderate arthritic pattern of uptake in the first MTP joints.

Summary: No evidence of oesteoblastic bony metastatic pathology. A small focal activity of the 7th anteriorly is likely related to prior bony injury. 

My thoughts: My prostate cancer first surfaced in November of 2006 during my annual physical with my GP. I was 56 years of age at the time. My PSA was elevated 6.0 ng/ml and DRE indicated hardening of the entire left hemisphere of my enlarged prostate. My PCa was staged at T2B following biopsy. I was treated with 9 months of neo adjuvant ADT (Lucrin as it is known in Australia), and 70 Gy of Radiation. My PSA was uneventful for 12 years then it commenced to rise ever so slowly over subsequent years. I reached the threshold for BCR (2.25 ng/ml) in 2024. I underwent a PSMA Pet Scan in October 2014. Small low grade uptake in apical prostate. Very small volume disease not requiring any salvage local treatment. No bony mets seen. One iliac region nodal uptake (SUV 12.14) activity. Node was left internal iliac node. Radiation planned for local node for temporary PSA control however during planning CT the node (size 4mm) was unable to be identified to target. Thus RT cancelled and a second PSMA scan scheduled in 3 months. Second PSMA in Feb 2025. Interval increase in avidity ( now SUV max 16.85) and a second node ( SUV 2.73, obturator node) was identified. So in a further 3 months we now have firther progression in the known node and a new node identified. Radiotherapy was given to both nodes (30 Gy and 25 Gy). PSA following Tx at 3/12 dropped 30%. PSA doubling time was never really an issue (18 to 24 months). And so here we are now stuck in a holding pattern with no active treatment for PCa. PSA bloods will be taken this week and I will report on that when available.

So my PCa journey will enter it's 20th year this year and with an initial staging of T2b, Gleason 7 (4+3), I never really expected to be in this situation in my twilight years. Still no requirement for ADT currently is a big plus, particularly give my heart failure issues.

Edited by member 08 Jun 2026 at 04:59  | Reason: Not specified

I have posted my journey on here in the belief that it may be of interest to some fellow members on here. I again find it necessary to reiterate that my focus is in science. To be clear, I have no interest whatsoever in social support, pats on the back, well wishes, and the like. "This is my story". I should be able to tell it as I wish, free from the well intentioned, but very irritating, unproductive sideline comments of you know who. I have history with this person. Their post adds absolutely nothing to the content of my story.

Moderators if you choose to delete my post, then I also request you delete the post that I refer to. You no doubt know who I mean.

Moderators you recently invited me to contribute to an article and if you are wondering why I did not respond, you have your answer.

Moderators should you value the post in question as having greater interest than my own and not remove the said post, then either delete my entire thread or I will alter my contents so as it is useless to any reader.

I am really fed up with the fellow's stalking and it has to stop. Thank you.

Well my PSA has been reported on. Again the see saw pattern continues, this time with a drop from 3.35 ng/ml to 2.9 ng/ml. Suffice to say the holding pattern continues without the need for any ADT whatsoever. So on the evidence to hand we have no PCa progression over the last one and one quarter years. Long may it continue.